The Battle Over Medicaid Work Requirements

 

Over at City Journal, I argue that we should pay more attention to the new wave of Medicaid reforms bubbling up from the states, especially the so-called work requirements. Back in January, Kentucky became the first state to announce “work requirements” as a condition for Medicaid eligibility. Well actually, it is a “community engagement” requirement which can be satisfied by working, looking for work, taking a class, going to rehab, and other productive activities. And it applies only to childless, able-bodied adults.

But still, the Kentucky program was blessed by the Trump Health and Human Services Department, so the Resistance is out in full force to halt the community engagement requirement. Within days of the Kentucky announcement, a coalition of liberal activist groups, including the dubious Southern Poverty Law Center, filed a class action lawsuit to block Bevin’s Medicaid reforms. While that lawsuit has been dragging on, Bevin has filed a counter-suit, and ten more states have sought to implement their own community engagement program.

So the battle is on, and the stakes are high. The rising cost of Medicaid is creating fiscal emergencies across the United States, eating up a quarter of state budgets nationwide, and crowding out spending on other priorities, like education and infrastructure. If states are not empowered to rein in these costs, it will strike a mortal blow to the system of cooperative federalism on which federal aid programs are based.

Published in Domestic Policy
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  1. Stad Coolidge
    Stad
    @Stad

    Adam Freedman: Bevin has filed a counter-suit

    Good.  Fighting back is something we need to do more of.

    • #1
  2. Susan Quinn Contributor
    Susan Quinn
    @SusanQuinn

    I hope the states persist. It is beyond me how people can’t see the value of people working and how it benefits them, not just financially but in terms of their own self-worth and feelings of accomplishment. I guess the Left wants to reinforce the belief that people are helpless and must be dependent on the government. It is an abhorrent idea. Thanks for this piece, Adam.

    • #2
  3. Ralphie Inactive
    Ralphie
    @Ralphie

    The idea is to overwhelm the system to collapse it.  That is what I have heard.  

    Or perhaps liberals don’t want them out and about in their communities. 

    I don’t believe that liberals really like and respect the underclass. I think they seem them as stupid lackeys. The best way to grow liberals is to infantalize adults.

     

     

    • #3
  4. Adam Freedman Contributor
    Adam Freedman
    @AdamFreedman

    Susan Quinn (View Comment):

    I hope the states persist. It is beyond me how people can’t see the value of people working and how it benefits them, not just financially but in terms of their own self-worth and feelings of accomplishment. I guess the Left wants to reinforce the belief that people are helpless and must be dependent on the government. It is an abhorrent idea. Thanks for this piece, Adam.

    Thanks for the comment.  Interestingly, the Obama administration allowed states to provide incentives for Medicaid recipients to do things like exercise and quit smoking, but they refused to countenance “work requirements.”  

    • #4
  5. RufusRJones Member
    RufusRJones
    @RufusRJones

    Ralphie (View Comment):

    The idea is to overwhelm the system to collapse it. That is what I have heard.

    Or perhaps liberals don’t want them out and about in their communities. 

    I don’t believe that liberals really like and respect the underclass. I think they seem them as stupid lackeys. The best way to grow liberals is to infantalize adults.

     

    All of this. Cloward and Piven.

     The GOP has to fix the damn health insurance system or we are going to get single payer good and hard. 

    • #5
  6. I Walton Member
    I Walton
    @IWalton

    Lets be cautious.  Remember some folks wanted to restrict welfare to households where there were no men who  could work but didn’t, or where there were savings.  This gave the current monstrosity in which only single mothers with no savings get welfare.  If it’s top down it isn’t going to work.  If it’s supposedly free it’s likely to do more harm than good.  So focus on the goals.  The goal isn’t to make sure nobody gets something they don’t deserve or that’s not warranted.  The goal is to provide medical care for the poor.  Charity hospitals, state hospitals open to anyone who wants what they offer worked.  Welfare in any form has always done more harm then good.  Liberals don’t like this but that’s an argument in its favor.  Work requirements for welfare added little and exclude  many who actually need it.  Of course the purpose of welfare is to create dependence so folks vote Democrat, and I’m not sure what other goals are served.  All we can know for sure is that a remote disinterested non accountable federal government can’t run it, can’t reform and and can’t end it.  Since we know it does great harm and is just political and we don’t seem to be able to do away with it, it should be transferred to the states with no mandates and federal monies  approaching zero in a short period of time.  Maybe some innovative states can figure out how to do it with minimum harm and maybe even how to get rid of it and still help folks who really are very poor for a short period of time and have no family.   

    • #6
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